McKenzie versus Stabilization
I admit that just a few years ago I was obsessed with “core” exercises where I wrote about all the studies showing motor control impairment and muscular dysfunctions in those with chronic low back pain (CLBP). I assumed that the only way to retrain muscles was to prescribe stabilization exercises.
I did not even think that it was possible for McKenzie based exercises to have any effect on muscles. Seems like I was wrong!
This RCT involved 70 patients with CLBP who demonstrated a directional preference using the McKenzie assessment.
Half the subjects were randomly assigned to receive treatments based on the McKenzie method and the other half received motor control / stabilization exercises. All subjects received 12 treatments over an 8 week period.
After the 8-week period, a blinded assessor measured various subjective and physical outcomes.
Result #1: There was no significant difference for pain or disability, as patients in both groups improved.
Result #2: Perceived recovery was slightly superior in the McKenzie group.
Result #3: Trunk muscle thickness of the transversus abdominis, internal obliques and external obliques equally increased in both groups!
Personal comment: Perhaps there are other reasons to explain why our patients get better such as the fact that both groups were empowered to self-manage their LBP!
Reference: Halliday MH et al A Randomized Controlled Trial Comparing the McKenzie Method to Motor Control Exercises in People With Chronic Low Back Pain and a Directional Preference. J Orthop Sports Phys Ther. 2016 May 12:1-30.